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HomeMy WebLinkAboutMiscellaneous - 9 Icehouse Road Unit 21CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building ]Permit Number 311 (10/21/2005) Date: March 13,,_2006 THIS CERTIFIES THAT THE BUILDING LOCATED ON 9 Icehouse Road MAY BE OCCUPIED AS Single Family Dwelling IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Mmgag, Hom common 121 ggggfteld Road North Andover MA 01845 Building Inspector m m m m m U) EP mm v y d C � d CO3 Cl) 'fl O CD Z C. O �. Cl CL = y aCO :g �CD � CD o p CDCL o Q CD CD CD CD C CD y� CL O CO) _ CD to CO) Cl 10CD Z 2 Cl CD0 C CD 0 I P cn cn C) O 0 O C C 9c;?A O —•rnoQ H _ m -0 y S O m C-) C2 CL Ml =r -fl y �o m y o CO) 4c o O y CE :� Co O a ao ec o C=D , A4O4 CD :�. rn o d • N G d C C C o ,c N CC2 m f m ti y c C am CaD d H� !C,14k6 CD moI . Sr 0 O z CA CA CD „•� CD Wim: Cn n -1 SIN". H dam: e CD so R's.: y � ca o�. 4 CL 0 c a- �j o CIO do KI) tTj c\ U \P CL 0 c ♦' Town of North Andover Building Department 400 Osgood Street North Andover Ma 01845 (978) 688-9545 Fax (978) 688-9542 -711-7160 r10RTF� O � ?_ coc.ac�w.cw APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS l 1 Ce �OLk V�-0A(X (0N Ir 2 LOT NUMBER 2 1 SUBDIVISION-,k&(n DATE REQUEST FILED 3/ L4 6 DATE READY FOR INSPECTION 311 :5Lo C� TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMP ED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENT - ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT T ALL APPLICABLE CODES. SIGNATURE 7- OFFICIAL USE ONLY ROUTING D.P.W. - WATER METER I 054c.t,C.Ie DATE 3 760 (a D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. k4 W SIGNATURE / DPW AUTHORIZATION Date...;? - C? -'6..... TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION y �7SSAC.MUSE1t This certifies that ............... has permission for gas installation .. iV .143G.s i........ . in the buildings of ..... � .. �E X11,% ............. . at .... �. H�?.5??r.... 12.1--) ..... , North Andover, Mass. Fee./� c- . Lic. No..d: C4r•` 2- .......................... GAS INSPECTOR Check 5436 1NIASSACHUSEM UNIFORM APPIICATON FOR PERMrr TO DO GAS FTrnNG (Type or print) Date Z NORTH ANDOVER, MASSACHUSETTS �Ce �% /�/�-t Building Locations Permit # � � Amount .$ !GG ✓ 14-yi� /� Owner's Name x New Renovation ❑ eplacement ❑ Plans Submitted ❑ • • (Print Name Addre Name of Licensed Plumber or Gas Fitter C one: Certificate Installing Company Corp. ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE • Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑, No❑ If ou have checked Les please indicate the type coverage by checking the appropriate box. Y1 13Liability insurance policy Q" Other type of indemnity 13Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ i hereby certify that all of the details and tntormatton t nave Sllnmtttea kor entereu) in aoove appucanon are true ana accurate to me best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachums�t. -Gas Cod�and Char 1W the General Laws. VED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber OS y� ❑ Gas Fitter LICense um er Taster Journeyman Date. . ;2 3 D6 TOWN OF NORTH ANDOVER 0 p PERMIT FOR PLUMBING SACMUS Ab c/�ve.. v��3��g.. �......� Of This certifies that ... ........... . has permission to perform ....!•�!�t�v............ plumbing in he buildings of .. l.�.H ............ �C'k#q E'".. &........ , North Andover, Mass. Fee. (7 .. Lic. No. r!�'-` �•............................. . PLUMBING INSPECTOR Check # MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location (c04 A� 2 i Owners Name ��. 4, New 1311"' Renovation of Replac ent ❑'Plans Submitted Yes T'TVTTIDL C Pate ermit # p.,.y Amount No 0 (Print or t; - Installing Address l4i Name of Licensed Plumber: Insurance Coverage: Indicate the pe of insurance coverage by checic Liability insurance policy Other type of indemnity Check one: Certificate ❑ Corp. Partner. Firm/Co. box: Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above threeinsurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massat s "49e Pl bing e a Chapter 142 of the General Laws. BY �e gMure Of is GGUJGU C1U IIlUGl Title Type of Plumbing License �� City/Town CT �L�License um er Master ❑ Journeyman APPROVED (OFFICE USE ONLY LJ nn��nnnnnn�nn=nn�nnnn i .J nnn nnnnnnnnnnmmmnnnnnnnnmmmn r.�n�■r�n��n�nn�inn�n�innnnin�nnnmmm S oI' nnnonnnnnnnnnmmmnnnn�nam ."Ice'nnnnnnnnMnnnnnnnnnnnnn�nn W I a' nnnMMnnnMnnnnnnnn�nnnnnnn •Mnnnnonnnnnnnnnnm mamma nnnn - I a.' nnnnnnnMnnnnnOnn nnMOM am I nmmmnmmmnnnnmmmmmmnnmmmnn nnnnnnnonnnnmmmmmmmmmmmnn (Print or t; - Installing Address l4i Name of Licensed Plumber: Insurance Coverage: Indicate the pe of insurance coverage by checic Liability insurance policy Other type of indemnity Check one: Certificate ❑ Corp. Partner. Firm/Co. box: Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above threeinsurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massat s "49e Pl bing e a Chapter 142 of the General Laws. BY �e gMure Of is GGUJGU C1U IIlUGl Title Type of Plumbing License �� City/Town CT �L�License um er Master ❑ Journeyman APPROVED (OFFICE USE ONLY LJ 1'6273 Date ..... ......... ... TOWN OF NORTH ANDOVER -PERMIT FOR WIRING + CH This certifies that ..... "(,.- ................................................. has permission to perform ......... ...... ............................................ wiring in the building of ....... 4 ............. at ...... ........... -n .............. . North Andover, Mass. elo .... Lic. N4r- '�7 . ..Fee A. ... .............. EL Check # —Z'94y��' DlrIDNl'OFPUBUCS0Tti7]r Permit No. BQAItDOFFMPREVF1N7MRFGVLA7IW527aoM aio � Occupancy � Feer Checked /•d APPUCATTONFOR PERANT'TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WTIH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMI; 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Town of North Andover To the Inspector of Wiles: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant'—)0,-v`- t—�rb Owner's Addmu 1- 1 r Is this permit in conjunction with a building permit; Yes No [:3 (Check Appropriate Box) Purpose of Building P -L- ,� c a-�J. ri 00 Utility Authorization No. Existing Service Ampa...� Volta OverheadUnderground No. of Meters New Servicer Amps t Volts Overhead Underground No. of Metes Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work [ A No of L. o ttg Outlsu No. or Hot Tuba No. of T mu"nme Total KVA No. of Lighting Fbttorn Swirming Pod" Above UCUA Below GOMM= No. of En"ncy UOdng Bmwy Uoits KVA Na of Receptecia Outisrs No. of OB Bums No. of Switch Outleu . No. of Os Buramt FELE ALARMS No. of Zana No. of Ranges No. of Air Cond. Taut Taus No, of Detections W No. of Dispouls No. of Heat Tout ToW Pawn Ton KW Ittidaft No Devices Sauoding Devices No. of Dishwuhms Space Ates Hemting KW No. of Sem Carubwd Detecdo3orJv,r Dsvlces Las, a - Na of Dry= Hadng Devices Kw . a No. of Wow Hester KW N66 d Na of sign Bsilnis No. Hydro Mmsge Tabs No. of Moron Total HP Ittateatxmttl�elr�I'�� '� � criisa*dviW IhmestftnkkdvWpoofdsanetote0MZ Yl� � � Yid 0 _ r)cuhmecteciedYB4,pkasi * tftetypedwv=&by MRANCB Bcm m on= Do WodcbStsttL � .� DteRa}�d Ragli E' dyak afBM"Wak S -Wtvlkrk ofpQ� FrLrl FWNAM <1>4rt,tJLc� _ CiomreNo �5�� UnnNo Z? err &td=TdNa 1,O�j 3 fsZ-Zoc, ovvrrtR'SAbURAI�WAIVQt;I awtredirtlhel d�,g��Iheiraaaneaneageori�a�bemryLl At ardtbe nsWanmft.' dw.1—ftlaquiema 't�104�bl+MrssadsltdhcenaWLM (Please check one) Owner ASM 13 a� Telephone No, prgH Mrr FEB �1 rI -� ILDA ly►/ 4:4hl Permit No. OccuVwxy R Fees Chechd APPUCATTONFOR PERMITTO PERFORM ELECTRICAL WORK All. woR[ TO BE PERFORMED IN ACCORDANCE wrrH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INMRMATION)-- Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical worst described below. Location(Street3Number) Owner or Tenant � �n.4 l.r<-t fir--( L �•' CJ-z.a J L-c•l,�..�. i C e� � i� - I,� ,r e Owner's Address t� • Is this permit in conjunction with s building permit: Yes No C3 (Check Appropride Box) 00 purpose of Building P.-C:5�4,, Utility Authorization No. Existing Service Ampa� Volts Overhead Urtdemound C3 No. of Meters _ New Servir�Q - Amps It. Overhead Underground No. of Metes Number of Feeders and Ampscity _ Location and Nature of proposed Electrical Work No of Lighting Ovum Na of Hot Tube No. of Tranatbrmm TOW KVA No, of Lighting Pott M Swinunina Pod Above Bskm Oatenten KVA around No. of RWAPtaeb Ou" Na of On Burma No. of E.mergenry Lighting Battery Unit No. of switch Outlet No. of Oa BOmm FORE ALARMS No. of Zones No. of Raatps Na or Air Cad. Taal Toes No. of Deleetlon and No. of Disposeb Na of Hest Total Total P"" TOM JEW laideft d Na of Deviaoes No. of Dishwasben Space Area Heating Kw Na of Self Ccntelned Lmd Mwdcipd Oth, No. of Dryers Hating Devisees Kw �. Connection No. of Weer Heaters Kw No. of No. of sizoo Beilmis io. Hydra Msnsp Tuba No. of Mown Total HP re -i smumm" `i iL1RAN(� BM [3 OMM �leeleS EstrralsdVAMdl�cwidl Wakes dtbSlaC 1.. l �� niseisecr,at,d itagt � �ledurtd"r P"bdpf*- MAMf3 �L���l rFC — �ZL�t�'tlL� C,- <,G.-,t.i,��c�' � � - LbmeNn int t i✓ t L .E c7��. U a-�s� Sp�,as„e �JU \ ' / HustleelTdNn Na fl FWSM2ANCEWAIVER;I sw=d>o ftLi=wd=w er netsloeana�arirs�seirlYt�giivakntasrec}itAkTd e®tfieebCet�ILawrt ease check one) Owner C:3 Agent Telephone No, r»tivfrr FEE ScILv O �G F1 Af/ /� 1-& 4A7 It I - Z /- (D i ') - 6 - 0 (, at-�� :5 - 8 .dam P,7 '�? Location No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ s��cMus Building/Frame Permit Fee $' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 1,12 18702 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCTREP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING ." .i, .;„-. ✓ �i,:M,°7�,C?a a>., y J �,. �.... ,.., Y-. 'Y': �i°S'�Sa, :,. Y'sf... } y, .� lw.'�+« Tc?..3.��'� i ^➢a, �c BUILDING PERMIT NUMBER DATE ISSUED: SIGNATURE: Building Commissioner/Inspector of Buildings SECTION 1- SITE INFORMATION 1.1 Property Address: ✓�I T Z� 1.2 Assessors Map and Parcel Number: O L . 3 � Map Numbs Parcel Numbs Nza Aj(,.Avl A 1.3 Zoning Information: SF -22 6” Zoning- Iiistrid Pr Use. 1.4 Property Dimensions: 3d, Z A C 7 � Lot Area Fronts ft 1.6 BUILDING SETBACKS tt Front Yard Side Yard Rear Yard R ed Provide red Provided ReqWred J Provided NJ 1A J\.)4 + 1 1.7 water Supply AGI—C.40. 34) 1.5. Flooa Zone Information: Pablio private ❑ Zone Outside Flood Zone 1.8 S erW Disposal System Municipal On Site Dis System ❑ SECTIO 2 - PROPERTY OWNERSHMAUTHORIZED AGENT Historic District: Yes No 2.1 Ownerrd M�of Xv- )Z,/ Name (Print) f Address for Service: Si Telephone Owner of Record: Name Print Address for Service: Signadre Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licc sed Construction Supemso : L tensed Construction Supervisor. / 1 / Address��z ---/// Telephone r Not Applicable ❑ _ V / 7 License Nu Number J_ Expiration Date 3.2 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name Registration Number Address 4 Expiration Date Signature Telephone v rn SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 4 2506) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes ...... No ....... ❑ SECTION 5 Description of Proposed Work(check all a Hcable New Construction X Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SEK SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by pennit applicant "(3FFCIia USE- QNLY , �: v 1. Building �( �U (a) Building Permit Fee Multiplier _ 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION 10 BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APP IES FOR BUILDING PERMIT 11 , as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in a matters relativ o w rk authorized by this building permit application/,))j J� Si i of caner Date SE ION 7b OWNER//AUTHORIZED AGENT ECLARATION I, Z) as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief ZLDO'd "e' /-1) , J c20) Print N Si Owner/A ent NO. OF STORIES L Date SIZE y BASEMENT OR SLAB SIZE OF FLOOR TMMERS 1 2 l> 3RD SPAN M DRAENSIONS OF SILLS DIMENSIONS OF POSTS " S DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION ' THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED OND SCS L IS BUILDING CONNECTED TO NATURAL GAS LINE t rA tv 0� w O w a aw a a o w v V) o w o rx C U G w 0. a°' cd w W w w o vi o cn • k ,Q = m O h C O wv �a•o aC O A O O dJ ZO" iEa _2 :tea H O� C 0 0 C.) w 3 os r► �'` a, E N t0 4-0 mm rc„ �m3 C y c C m y N O _O o c m m� m o, o Q p � m O •� O co CL Q ` go O C O = o :a 1-4 W F.. •y O C Z W •E v��h O CO3 a • O S 1-- _ o y •� O aim CI 4..1 O O V Z o. O h o o, CD �- M E m m CD CD CD 3� CD ca Q cc o C- � cma c Co � c ev Ci O CD ca ts O Z CD a V co C m - - c c _cc d COD is U) W W W CO) FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements- ************** -***************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT I f_1. . Co. . tnp71$ LL(_ PHONE 6-C87-2635 LOCATION: Assessor's Map Number /�yC PARCEL 3 f SUBDIVISION l" t�� �oLS2 /�?�li LOT (S) Z� STREET —1- Com. �_OC6e'tq- Q ad ST. NUMBER_ *****************************************OFFICIAL USE ONLY *********** RECOA&ENDATIONS OF TOWN AGENTS: ATION ADMINIVKATOR DATE APPROVED DATE REJECTED COMMENTS IVO� I cSd1,G.� Iva A TOWN PLANNER • DATE APPROVED _ DATE REJECTED COMMENTS CG *N . Li O R FO TH SEPTIC INSPECTOR -HEALTH COMMENTS 0M S a W E DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR Revised 9\97 j m /d/��o.s--' DATE MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.3 Release lb Data filename: Untitled TITLE: The Nantucket at Meetinghouse Commons CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: I or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 10/13/05 DATE OF PLANS: 09/01/05 PROJECT INFORMATION: Meetinghouse Commons North Andover, Ma 01845 COMPANY INFORMATION: Meetinghouse Commons LLC COMPLIANCE: Passes Maximum UA = 477 Your Home = 447 6.3% Better Than Code Ceiling 1: Flat Ceiling or Scissor Truss Wall 1: Wood Frame, 16" o.c. Window 1: Vinyl Frame, Double Pane with Low -E Door l: Solid Floor 1: All -Wood Joist/Truss, Over Unconditioned Space Furnace 1: Forced Hot Air, 90 AFUE Air Conditioner 1: Electric Central Air, 10 SEER Permit Number Checked By/Date Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R -Value U -Factor UA 1628 0.0 30.0 50 2356 0.0 13.0 186 379 0.340 129 35 0.340 12 1628 0.0 19.0 70 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.3 Release lb and to comply with the mandatory requirements listed in the MECcheck InspecA.1310andJ4.4. klist. The heating load for this building, and the cooling loadnate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equected to heat or cool the building shall be no greater than 125% of the design load ass cified in Sections 7 Builder/Designer Date % MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.3 Release lb DATE: 10/13/05 TITLE: The Nantucket at Meetinghouse Commons Bldg. Dept. Use Ceilings: 1. Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 continuous insulation Comments: Above -Grade Walls: 1. Wall 1: Wood Frame, 16" o.c., R-13.0 continuous insulation Comments: Windows: 1. Window 1: Vinyl Frame, Double Pane with Low -E, U -factor: 0.340 For windows without labeled U -factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: Doors: [ ] 1. Door 1: Solid, U -factor: 0.340 I Comments: Floors: 1. Floor 1: All -Wood Joist/Truss, Over Unconditioned Space, R-19.0 continuous insulation Comments: Heating and Cooling Equipment: 1. Furnace 1: Forced Hot Air, 90 AFUE or higher Make and Model Number 2. Air Conditioner 1: Electric Central Air, 10 SEER or higher Make and Model Number Air Leakage: Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.571bs/ft2 pressure difference and shall be labeled. Vapor Retarder: [ ] Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. Materials Identification: [ ] Materials and equipment must be identified so that compliance can be determined. [ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. I Insulation R -values, glazing U -factors, and heating equipment efficiency must be clearly marked on the building plans or specifications. Duct Insulation: Ducts shall be insulated per Table J4.4.7.1. Duct Construction: [ ] All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] ( Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Heating and Cooling Equipment Sizing: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. Table I: Minimum Insulation Thickness for Circulating Hot Water Pipes. Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Rane F 2" Runouts l" and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature Low Temperature Steam Condensate (for feed water) Cooling Systems Chilled Water, Refrigerant, and Brine 201-250 1.0 Insulation Thickness in Inches byte Sizes Heated Water Non-Circulatinp- Runouts Circulating Mains and Runouts Temperature (F) U to 1" Up to 1.25" 1.5" to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Rane F 2" Runouts l" and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature Low Temperature Steam Condensate (for feed water) Cooling Systems Chilled Water, Refrigerant, and Brine 201-250 1.0 1.5 1.5 2.0 120-200 0.5 1.0 1.0 1.5 Any 1.0 1.0 1.5 2.0 40-55 0.5 0.5 0.75 1.0 Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) The Commonwealth of Massachusetts Depaninent of Industrial Accidents �I Office of Investigations Ii a 600 lVashington Street Boston, MA 02111 `'M s•y",mmass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Annlicant Information Please Print Legibl- Name (Business/Organization/Individual): Address: City/State/Zip: N , 2,t '. d) J -41r Phone #: 5 Z63 Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2 1K I am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t These sub -contractors have workers' comp. insurance. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. .XNew construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.0 Other *Any applicant that checks box #{ 1 must also fill out the section below showing their workers' compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. 1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year Imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coveragVWrification. I do hereby certify under the ins a saltie of perjury that the information provided !40velstrue and correct: Date: GS Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other �I Contact Person: Phone #: BOARD OF BUILDING REGULATIONS ..;; License: CONSTRUCTION SUPERVISOR Number: CS 055417 Birthdate: 04/05/1960 Expires: 04/05/2006 Tr. no: 21033 Restricted: 00 THOMAS D ZAHORUIKO 121 CARTERFIELD RD N ANDOVER, ?>/IA 01845 Acting Cc mis oner I ,9 Z �� Q u u s � 0 c o E E _ N c O � c u u + to O Q O o Q z J o E 0 O ej u . ro c F \ � o c�0 Z u �-" Q -C t z m T) N �� Ot r Y 9-9( r �� o..ol g, a � i ' o� n�L Q •.Z. l p- O R O 16 OF_ ..,----•---7 Q^� �..h I i N Q U U S l� � � o N G E 0 J s •� � _ � O Q N 0 o m � C J N 0 E EO O CC L Q _ II \ v „ 0 cp �-- o z u T) u 9,0 J a -r I tt, 7 411, a -- t � Q u u s �= � 0 N C 0 E E 0 U 0 �C N E O O N \z o � Q ....c 0 U Q ^u O C 0 E 0 u u C 0 C Q F N 0 N t Z vJ 7 411, a -- t _H 1 0- 0-7) 0- C� s U -j q � (1 v J L N cQO E E 0 r 1 c s`^ � � " C � O Q � O N N 0 O Q c 0 'z11 J J C 0 o E o 2 o 2 N U C N Z E--z�� L j Q s ou II \ 0 1 G a� J U -j q � Q u u s lI) � o N G 0 E _ N O N O O Q oz o O d N z�� CIO M 00 M Goa, N clot M 000 ��al �n ���1 V)�n �1 Y\ x x x X x x 1^i x Yti ✓ti V 00 d O M 00 O_ M O d N oo N N M �y 00 - d 00 0 0 V) cd U � � V ) bnbO01) b!J O00 � O O va Q o - N M d LnF- � Q u u s lI) � o N G 0 E _ N O N � C V � u Q oz o O E 0 z�� u u 1� .c cR u7'l ZY kl 'f1 . \l • .i w Q u I � v J L ' 0 N o E V N _ V\ o Q o Q c z iil fA S N W) 4J -C� G + m o Q � oV1 Q ..J o E 0 U Z u f-- L > o Q s t ZU� C u ro V N V1 0 Ij P .c cR u7'l ZY kl 'f1 . \l • .i w Q u � v J L ' 0 N o E V N _ V\ o Q o Q c z S N W) 4J -C� G + m o Q � oV1 Q ..J o E 0 U Z u f-- L > o Q s t ZU� C u ro V N M -; I o- f& ; p'4t n -l' i i N U., LJ- u. r� � 1r x v l L � C E E _ N O O C Q _c ^ dJ Q E 0 � J O o C Z I—ZT� C J � I p'4t n -l' i i U., LJ- u. r� N I 004 1r x ('F' .9 J v a vu w � J 46 'o 4 e L9 w a J � I 0 I I Cj *SqAb--- E 0 E � 0 N c � c o E E O s 0 c N 0 U 2 o 1 co u O Q O O Q E O O L U N u 0 z *SqAb--- E oil 9 a Y -t L c[ - -' 1 - FL q co �f Q^�[ dr n -A � d r 0 6 N Q 0 T N 0 E (0 v 7 0 u � L C O 1 0 � z � O 4 � I —C , � � 0 � G � .� •--� 44 O � N � C E Q 0 O L G \ 0 Q � c[ - -' 1 - FL q co �f Q^�[ dr n -A � d r 0 6 0 QD Q r N N u c 0 E E 0 L # �, c u --r- T) T) v� 0 N �= -n G 1 0 v s � Q Oz 0 E � z� U z R " 0 QD Q r N N i Q - 0 u L C TO0 � O � ' l s Q E 00 140 u � u � z 7T Al -7--- o -o1 ' 4-h ' 0- o-zz v1\ Q o O E � sO Q 0O +NtLo z oocgrnoo-�cuL �p v1 Lr) L � N \� \ 00 00v N C M M Q© hl d C� CO d pp p c Q E fS L O �O > II +- > V) -170 c Q 4 \ 1 "Z) z��. CIO u t ap +� a, bn 4 3 a� 0' CO N CIO U � 00 M 'Z7 OCIO p N r U Q � v1\ Q o O E � sO Q 0O +NtLo z oocgrnoo-�cuL �p v1 Lr) L � N \� \ 00 00v N C M M Q© hl d C� CO d pp p c Q E fS L O �O > II +- > V) -170 c Q 4 \ 1 "Z) z��. CIO u t ap +� a, bn 4 3 a� 0' CO 1 U � 00 OCIO p N Q O v1\ Q o O E � sO Q 0O +NtLo z oocgrnoo-�cuL �p v1 Lr) L � N \� \ 00 00v N C M M Q© hl d C� CO d pp p c Q E fS L O �O > II +- > V) -170 c Q 4 \ 1 "Z) z��. CIO u t ap +� a, bn 4 3 a� 0' CO �5Q 0 L --C U C E 1J f: 0 0 E 0O Q �C E N --C ° t NI ---I Z s ! u rn z 4 0 6� to ty 10 � a � � ....;. ��:j, .a Cl I 1 .-,.• - - . _ __� IN I Q �5 SIF Q ,h 0 S IZI N Q N C � ' 1 \J C Q Q C z N c s � � O V � M U U Q ro O .._1 � 0 E ro G ro � G _ E--ZU� 0 6 V*)v� � 'D :r „flM�TT 0 i 0 0 6 0 oy r� rro nx;nc�rt'+1 CERTIFICATE OF USE & OCCUPANCY Building Permit Number , 311. (10/21/2005) Date: IvlarGl� _l 3z 2006 __ ___,.•_ THIS CERTIFIES THAT THE BUILDING LOCATED ON 9 Icehouse Road MAY BE OCCUPIED AS Single Family Dwelling IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to; Meeting House Common 121 Carterfield Road North Andaver MA 01845 Building Inspector __ 4k rA W 4WERNIP W in 6 am z z 0 c/) z 0 C-) a mi 164, -3 z cf) o 0 U7 c A—�, 10 r, :3 w go c/) C/)- 4WERNIP W in 6 am z z 0 c/) z 0 C-) a mi 164,